Individual provider Active NPI

Racheal Denise Gallant, PTA

  • Physical Therapy Assistant
  • Pataskala, OH
National Provider Identifier
1073171583
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA.012221 Issued in OH
Practice address
129 Kelly Marie Dr
Pataskala, OH 43062-8148
Phone
(903) 987-5090
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA.012221 OH Primary

Addresses

Primary practice location

129 Kelly Marie Dr
Pataskala, OH 43062-8148

Mailing address

339 E Maple St
North Canton, OH 44720-2593
Phone (330) 498-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA.012221OHMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1073171583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 E MAPLE ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202593",
            "telephone_number": "330-498-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 KELLY MARIE DR",
            "city": "PATASKALA",
            "state": "OH",
            "postal_code": "430628148",
            "telephone_number": "903-987-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "RACHEAL",
        "middle_name": "DENISE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA.012221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pataskala, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.